Professional Certification Program
Model Optimal Care Academy
Professional education for the people who manage, advise, and optimize employer-sponsored health plans.
The CP-MOC Certification
Certified Professional in Model Optimal Care — the credential that proves your mastery of data-driven, fiduciary-grade health plan management.
CP-MOC
Certified Professional in
Model Optimal Care
What Is the CP-MOC?
The CP-MOC designation is a professional certification for individuals who demonstrate mastery of the Model Optimal Care framework. It is designed for benefits directors, HR executives, consultants, brokers, TPAs, and other professionals who manage or advise employer-sponsored health plans.
This certification covers the full scope of the MOC framework: Transparency, Accountability, Integration, Engagement, and Technology Enablement. Candidates complete a structured, self-paced online course, pass a comprehensive assessment, and earn a credential that signals their commitment to data-driven, fiduciary-grade health plan management.
What You Will Learn
Course 1
Foundations of U.S. Healthcare Waste and the Model Optimal Care (MOC) Framework
Foundations of U.S. Healthcare Waste and the Model Optimal Care (MOC) Framework
principles, the dual-pronged methodology, and three pillars that define the Model Optimal Care framework.
Course 2
Employee Engagement and Non-Technology Cost Reduction Strategies
Employee Engagement and Non-Technology Cost Reduction Strategies
comparison shopping, and ancillary benefits optimization that any self-insured employer can deploy right away.
Course 3
Clinical Management and Data-Driven Decision-Making
Clinical Management and Data-Driven Decision-Making
telemedicine, medical case management, and data-driven decision-making for chronic
conditions.
Course 4
Technology-Driven Claims Auditing and Payment Integrity
Technology-Driven Claims Auditing and Payment Integrity
detection.
Course 5
Pharmacy Optimization, Price Transparency, and AI Strategy
Pharmacy Optimization, Price Transparency, and AI Strategy
machine-readable files, Medicare benchmarking, and a 90-day AI deployment blueprint.
Course 6
Regulatory Compliance, Employer Leadership, and the Future of MOC
Regulatory Compliance, Employer Leadership, and the Future of MOC
Who Should Earn The CP-MOC Credential
- Benefits Directors and HR Leaders
- Employee Benefits Brokers and Consultants
- TPA and ASO Account Managers
- PBM Analysts and Pharmacy Consultants
- CFOs and Finance Professionals
- Healthcare Policy Analysts
Enrollment Opens Soon
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Course Catalog
The Model Optimal Care Academy offers a growing library of professional courses for healthcare benefits professionals. Each course is designed to deliver practical skills you can apply immediately after taking each course.
Foundational
Becoming Self-Insured: A Primer
A foundational course for organizations considering the transition from fully insured to self-funded health plans. Covers the economic drivers behind self-funding, the regulatory framework under ERISA, stop-loss coverage structures, vendor selection (TPA, ASO, PBM), plan design fundamentals, and a 15-week implementation timeline. Ideal for HR leaders, finance professionals, and benefits consultants advising mid-market employers.
Risk Management
Risk Modeling Fundamentals
Learn how to assess, quantify, and manage risk within self-insured health plans. Covers actuarial concepts in accessible terms, including specific and aggregate stop-loss thresholds, risk modeling, risk stratification, large claims probability modeling, and demographic risk adjustment. Build skills in evaluating plan exposure, setting clinical groupers and AI models, and communicating risk scenarios to executive stakeholders.
Analytics
Data Analytics Fundamentals
A practical introduction to healthcare data analytics for benefits professionals. Covers core concepts in claims data structure, key performance indicators for health plan evaluation, population health metrics, trend analysis, and benchmarking. Includes hands-on exercises in interpreting medical and pharmacy utilization reports. Designed for professionals who work with data daily but want a stronger analytical foundation.
Reporting
Report Building Fundamentals
Learn how to design, build, and present executive-level health plan reports that drive decision-making. Covers report design principles, data visualization best practices, narrative construction for different audiences (C-suite, benefits teams, employee communications), and dashboard layout. Includes templates and frameworks for large claims summaries, pharmacy savings analyses, ER utilization trends, and risk utilization dashboards.
Infrastructure
Data Warehousing for Health Plans
An introduction to data warehousing tailored for the self-insured health plan ecosystem. Covers data architecture fundamentals, ETL processes for medical and pharmacy claims, data integration across multiple sources (eligibility, labs, wellness, premiums), data quality and validation, and the role of a centralized data repository in supporting analytics, reporting, and AI-driven insights. Designed for technical professionals and benefits leaders.
More Courses Coming Soon
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